Location of fire on property
(e.g. in barrel behind old shed at back of property):*

Is this a recurring problem:*

No
Yes

What day or time does this most often occur?

Description of the problem:

Please provide your name, address, and a way to contact you in case we need more
information and to inform you of the results of our investigation. This information
is optional unless you are making a complaint based on a nuisance.

Name:

Address:

Telephone:

Email Address

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